TAILIEUCHUNG - Báo cáo khoa hoc:" Fatal miliary Coccidioidomycosis in a patient receiving infliximab therapy: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Fatal miliary Coccidioidomycosis in a patient receiving infliximab therapy: a case report | Journal of Medical Case Reports BioMed Central Case report Open Access Fatal miliary Coccidioidomycosis in a patient receiving infliximab therapy a case report Mark P Rogan and Karl Thomas Address Department of Internal Medicine Division of Pulmonary and Critical Care University of Iowa Hospitals and Clinics Iowa City Iowa USA Email Mark P Rogan - mrogan@ Karl Thomas - karl-thomas@ Corresponding author Published 5 September 2007 Received 15 June 2007 _ . - - - n I Ift I-7I- 10 -7 I -70 Accepted 5 September 2007 Journal of Medical Case Reports 2007 1 79 doi 1752-1947-1-79 This article is available from http content 1 1 79 2007 Rogan and Thomas licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract A 78-year-old white male from Iowa in the United States of America receiving the anti- tumor necrois factor TNF agent infliximab therapy for rheumatoid arthritis developed a cheek ulcer which failed to respond to empiric antibiotic therapy. He subsequently presented with progressive respiratory failure from miliary coccidioidomycosis which proved fatal. The patient vacationed in Arizona 6 months previously and likely contracted the organism there as Iowa is not an endemic area for coccidioidomycosis. Respiratory failure from miliary infiltration is an uncommon presentation of coccidioidomycosis. Physicians should be aware of the importance of travel history and potential for life-threatening coccidioidomycosis in patients receiving tumor necrosis factor inhibitors. Background Tumour necrosis factor-a TNF-a is a cytokine that plays an important role in inflammation. In pathophysiological conditions generation of TNF at high levels leads to the development of inflammatory

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